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Damage Case
is the twenty-fourth episode of the second season and the 33rd overall episode of Grey's Anatomy. Short Summary Anger is in the air, as Derek is angry at Meredith for seeing McVet, Burke is angry at Cristina for falling asleep before he finished, Alex is still angry at She-Shepherd pulling him off surgery, Callie is angry at George for not defending her and the patients of a car crash are angry at the doctor responsible for the crash. Full Summary Finn's making breakfast for Meredith, who announces she doesn't cook, so she doesn't expect him to cook for her. He tells her to sit down and act like she's not scary or damaged. She denies that she is. He asks about her family. She says her not wanting to talk about her family doesn't make her scary or damaged. He asks about the last guy she slept with. In the bathroom, Meredith's telling Izzie about Finn. Izzie can't believe they've had four dates and two sleepovers without having sex. Izzie is really proud. Callie enters, wearing only panties, and sits down to pee. She flushes and leaves. Meredith and Izzie can't believe that just happened. Izzie says she didn't even wash her hands. Izzie's talking to George about the thing with Callie. They join the other interns in the ambulance bay as Izzie says that Callie crossed a line. Alex asks if they're still pretending she's not dating a patient. Cristina tells them to live and let live. She's cheerful because she got to scrub in and got laid, and now there are ambulances coming in with bloody car crash victims. She does a cheery dance, almost hitting Derek in the face. He passes by and asks Meredith about his dog. She says he's good, and corrects him. Doc's their dog. Derek is seemingly mad, but he says it's not the time to talk about it. A first ambulance arrives. The patient is Noah Reynolds, a 25-year-old restrained driver. His vitals are stable, but he has pain in his knee. Izzie takes him to bed 3. Cristina takes Noah's wife inside while Noah tells the doctors what happened. This car drove into Melanie's parents' car, and then that car hit his and Melanie's car. Melanie's taken into trauma room one. She got all the impact. Melanie is pregnant. She claims she's fine and asks them to just check on her baby and her family. She needs to know if her parents are okay. George brings Melanie's parents in. Her mother is loudly complaining about pain and her father refuses to stay on the gurney. While Cristina's checking for a fetal heartbeat, Jim enters the trauma room. The baby turns out to be okay, which Jim reports back to his wife. Meredith brings in another car crash victim. Betty recognizes him as the guy who hit them. Jim wants to hurt him, so Richard and George have to hold him back, but Betty tells him to hold his horses because the guy's already hurt. Bailey instructs George to accompany Meredith to trauma room and asks them to page neuro and ortho. Meanwhile, Alex wants to examine Betty, but since she doesn't have any panties on, she requests a lady doctor. Meredith informs the others that their patient is Marshall Stone, intern over at Mercy West. Marshall has no clue what happened. Derek asks Marshall to remember the words "bat, orange, and car". Derek says he has a closed head injury so they have to watch out for confusion, loss of consciousness, and vomiting. He asks Meredith to let him when the CT reports are back. Meredith asks Marshall about the words, but he only asks what happened. Bailey, George, Alex, and Izzie are watching Betty's and Jim's scans. They can both be discharged. Alex has to take Noah to the OR for surgery. Addison comes in and reminds Alex he's supposed to be rounding on her patients. He says he got paged 911 about a pregnant mom. Addison says she was going to ask him to scrub in, but now they'll see to it that Alex doesn't leave Melanie's side. She leaves. Alex complains about Addison, but Bailey supports her. Melanie's about to have her scan taken. She talks about her baby shower. That's why her parents were in town. Alex comes in and Cristina leaves him to take care of Melanie, but not before telling her that Alex likes to chat. Marshall's reading his own chart because he wants to know what caused him to swerve his car into oncoming traffic. He asks about the people he hit. George says they're still being checked out. Izzie comes in and tells Callie that she's her intern, so she'll be joining her for Noah's surgery. Callie tells her to prep Noah. Izzie gestures at George as if she's washing her hands, causing George to shut the door on her. George walks up to Callie and asks her if she washed her hands. She says of course. She then reduces Marshall's wrist fracture. Derek comes in to see if the CT results are back yet. Marshall wonders why he hasn't had a CT when his GCS is 13. Meredith says CT was backed up, and Marshall is lucid. Derek yells to get it done. Cristina joins Burke and asks if he's got something she can scrub in on, but he ignores her. She follows him and asks what's wrong. He says she fell asleep this morning in the on-call room. She fell asleep while they were having sex. She says she's sorry. She was seriously tired. She tells him not to let it threaten his manhood. She says she had already finished twice, but he says he didn't. She tells him to calm down, it's not like she did it on purpose. He asks why she was even at the hospital last night, since she was not on call. She wanted to observe a surgery she'd never seen before. Cristina says she's a surgeon first. Burke says he is a person first. Izzie was paged because a nurse found Denny collapsed in the hallway. He says he went too far too fast. Izzie says his battery's almost dead. She runs off to get Burke while the nurses help him to his room. Denny tells Burke he wants to go home. Burke says that's not an option. Denny wonders since when Burke decides what is an option in his life. It's still his heart, so it's his decision. Burke says it's his life that'll end if Denny continues to push like he did today. Denny thought the LVAD would make him better, but Burke says it only buys him more time, if he respects its limitations and his own. Outside the room, Izzie asks Burke what they do now. He wants to keep Denny on a tight leash. They can't control the damage to Denny's spirit. He can't imagine what it's like for a man like Denny to have to lie in a bed for years. He advises Izzie to give Denny room to grieve. Bailey, Alex, and Cristina look at Melanie's scans as they come up. All her organs are out of place. Bailey asks to have Shepherd, Montgomery-Shepherd, Burke, the Chief, and every available surgeon paged to the OR. They rush to Melanie to prep her. Callie asks George if he's seen Izzie, because she was supposed to prep an OR for Noah, but she bailed. George ignores her and walks into Noah's room to talk to Melanie's parents. He tells her that Melanie's body was filled with adrenaline, which kept her up and talking and pain-free. During the CT scan, her body relaxed and she succumbed to the full extent of her injuries, which are catastrophic. The surgeons are opening Melanie up. It's crowded in there with every surgeon doing their part. Addison instructs Alex to sit down and watch the fetal monitor. He hates to be demoted to babysitter. The Chief tells Addison they're ready for her. George assures Melanie's parents they're doing everything they can. Addison's protected the uterus and the baby's safe, so the others can proceed with the mother. Melanie's pressure bottoms out. They start packing her with lap pads. Burke clamps the aorta. It comes down to the fact that everyone is doing damage control. Richard announces they're just doing crisis management now. Once Melanie hits the triangle, they stop. No exceptions. Alex asks what triangle. Cristina informs him about the triade of death: blood stops clotting, muscles produce acid, and organs get cold. Marshall tells Meredith that he scrubbed in on an abdominal aortic aneurysm. It's a 12-hour surgery. He'd already worked 30 hours but he didn't want to miss it. He only closed his eyes for a second. He'd worked that many hours before. Meredith says they all have. Marshall says he may have killed a pregnant woman because he was saving a life. The CT tech comes out into the hallway. Meredith stands up and tells her they need a moment. When she turns around, Marshall's gone. Izzie brought Denny really great chocolate and tabloids, but he's not in the mood to be cheered up. She thinks he needs a little perspective, but he says she has no idea what it is to lose what he's lost. He's a strong, viril man stuck in a sick body. If Izzie truly knew what that feels like, she would have let him go. In the OR, the anesthesiologist says Melanie pressure's not getting better. Her spleen is unsalvageable. Alex informs Addison that there frequent decels and a loss of variability. They have hit the triangle. The surgeons reluctantly take their hands out. Melanie has a slow and erractic heartbeat. The baby's holding steady. They cover Melanie up with plastic so they can take her to the ICU to see if she survives. Derek looks up and sees Marshall in the gallery. Derek's yelling at Meredith for losing her patient. Meredith says Marshall's an intern at Mercy West. Derek says in this hospital, Marshall's a patient in need of a CT and who doesn't need to see the extent of the injuries of the woman he hit with his car. Derek tells Meredith to take responsibility for her actions for once. Bailey's updating Melanie's parents. Jim asks how long she's gonna have to stay open. Addison says it's a balancing act between going in to repair damage as soon as possible and Melanie gaining strength. Betty doesn't quite understand. Bailey says Melanie will die if they take her back to the OR too soon or too late. Bailey asks Cristina to call her if Melanie starts actively bleeding. Alex wants to leave, but Addison instructs him to stay and watch the fetal monitor. A baby can survive for five minutes in a dead mother. Everyone around Melanie is only looking out for her. It's Addison's job to look out for the baby. She has a surgery to perform, so she needs Alex to be responsible for the baby. He cannot let her down. The interns are talking about Melanie and Marshall. They talk about times they've fallen asleep. George comes over and tells Izzie that Callie's looking for her. Izzie says she had a patient, Denny. She doesn't want George to talk about standards since Callie doesn't even wash her hands. They all giggle, except for George, who walks off. Cristina tells Meredith not to be worried about Bambi forgiving her. If Burke can forgive her for falling asleep during sex, George will forgive her for crying. Meredith says Burke hasn't forgiven Cristina. Callie's with Noah. George comes in and tells her that Izzie had a patient. Callie knew that George would take Izzie's side. She tells George that Noah needs an IV and leaves. Noah says Callie's mad at George and asks what he did. George asks if anyone's talked to him about his wife. Noah can't wrap his brain around what's happening. He says he's from Seattle and he came back from college married to a Southern girl. He truly loves her. What's happening is that his Southern girl could be dying. He needs to think about something else, something that doesn't matter much. George tells him about the washing hands thing. Meredith paged Derek for Marshall's CT results. Derek takes a look and says everything's fine. His memory loss was due to the concussion. To be safe, Derek wants to keep him here for observation overnight. Marshall wants to apologize to Melanie's family for what he did. Derek tells him to rest. Meredith follows Derek into the stairwell and says she shouldn't have told him about George. Derek says he's glad to know about him and the vet. He tells her it's unforgivable. He asks who's next. He guesses Alex, since he, too, likes to sleep around. Meredith says Derek doesn't get to call her a whore. When she met Derek, she thought she had met the person she was going to spend the rest of her life with. She was done with the boys and bars and daddy issues. Derek chose Addison over her and she's finally glued back together now. She makes no apologies for how she chose to repair what he broke. Derek tells her this thing between them is over. She agrees. Burke and the Chief are checking on Melanie's. Her pH and temperature have risen. Her blood's clotting better, but some of the wounds are still oozing. She may not be stable enough. Betty says there's no need to whisper. She understands it's a big decision. She thinks she should be involved in it. Melanie's always asked her everything. She's Melanie's mama and it's her job to have an answer. She may not have an answer here, but she's still Melanie's mama. Bailey thinks Melanie will go into multiple organ failure if they wait longer. Richard announces it's time to go back in. In the OR, Derek is done. Cristina can wash out the abdominal cavity. Burke has resected a part of the lung. Alex announces the fetal heart rate is down to 80. Melanie's heart rate slows down as well. Bailey finds a retroperitoneal hematoma, but she can't find the source. Melanie's blood pressure disappears and the heart rates continue to slow down. Burke shocks the heart with the internal paddles. Richard sends Alex to get Addison. Alex arrives in Addison's OR and tells her about Melanie. Addison can't leave this patient and her baby, so Alex is gonna have to do what he can. Addison speeds up. George is with Noah and Melanie's parents in Noah's room. Jim wonders if there's anything he should do, but George says he's doing everything he can do. Meredith opens the door. George comes closer. Meredith says Marshall would like to apologize to the family. He's one of them. George nods. Alex returns to the OR, where Melanie's been down for 5 minutes. Alex decides to do a C-section and asks the others to tell him what to do. Bailey helps him to expose the uterus and talks Alex through the C-section. He takes the baby out. It doesn't look good. Melanie keeps bleeding profusely. Bailey can't get it controlled. Burke says she's not coming back. Richard decides to stop. He calls time of death 19:48. Addison arrives as Alex gets the baby to cry. Bailey's looking at Melanie's body while nurses are cleaning up the OR. Richard comes to stand with her. George arrives in Marshall's room with Big Jim. Marshall tells him he's so sorry. Jim approaches Marshall and reaches for his neck, but then places it on his shoulder instead. Marshall holds it and starts sobbing. George notices that Meredith's crying as well. Jim leaves and George follows him. Izzie sits down on Denny's bed. He tells her she's gonna get in trouble. She doesn't care. She takes off her shoes and lies down on Denny's chest. Burke's made dinner for himself. Cristina sits down with him. They're both tired. He takes a book and starts reading as she stares at his face. Alex watches through the nursery window as Noah's meeting his baby. Addison tells Alex he did good work. He says the kid's alive without a mother. George and Meredith are in the intern locker room. George tells Meredith he'll see her at home and leaves. Izzie's still lying in Denny's arms. He asks if it'd be wrong for him to feel her up right now. She says not so much. They giggle. She says he's a dirty boy. He knows. George is in Callie's room in the basement. She tells him she went down to wash her hands in the kitchen. She didn't do it in the bathroom because Izzie and Meredith were staring at her like she was a rodent. She was having the high school naked dream, only now it was actually happening. She didn't know they were home. George lies down with her. Callie tells him he has to stand up for her. She gets comfortable in his arms. He apologizes. Meredith's hovering as Finn is cooking. Meredith says this could be a mistake. Finn is a nice guy, so he wouldn't want to get involved with her if he knew her, her family, and all the guys she's slept with recently. He says he was right about her being scary and damaged. She thinks the scary and damage may be more than he can handle. Finn says his mother is dead. She died from cancer when he was 10 after suffering for a very long time. His father never recovered. He became a drunk. The last woman he slept with was his wife, but she died in a car crash. She didn't suffer. Finn says he's thinking his luck has begun to change, because he's met Meredith. She likes dogs, and birthing horses, and she can save lives. He never said he wasn't scary and damaged himself. Meredith leans in and kisses him. They smile. Cast 224MeredithGrey.png|Meredith Grey 224CristinaYang.png|Cristina Yang 224IzzieStevens.png|Izzie Stevens 224AlexKarev.png|Alex Karev 224GeorgeO'Malley.png|George O'Malley 224MirandaBailey.png|Miranda Bailey 224RichardWebber.png|Richard Webber 224AddisonMontgomery.png|Addison Montgomery-Shepherd 224PrestonBurke.png|Preston Burke 224DerekShepherd.png|Derek Shepherd 224FinnDandridge.png|Finn Dandridge 224CallieTorres.png|Callie Torres 224MarshallStone.png|Marshall Stone 224DennyDuquette.png|Denny Duquette 224JimJohnson.png|Jim Johnson 224MelanieReynolds.png|Melanie Reynolds 224NoahReynolds.png|Noah Reynolds 224BettyJohnson.png|Betty Johnson 224CTTech2.png|CT Tech Jeffrey (with Cristina and Alex) 224Paramedic2.png|Paramedic #2 224CTTech1.png|CT Tech #1 224RaytheParamedic.png|Ray Sutera the Paramedic 224Anesthesiologist.png|Anesthesiologist 224NurseMaria.png|Nurse Maria (with Denny Duquette) Main Cast *Ellen Pompeo as Dr. Meredith Grey *Sandra Oh as Dr. Cristina Yang *Katherine Heigl as Dr. Izzie Stevens *Justin Chambers as Dr. Alex Karev *T.R. Knight as Dr. George O'Malley *Chandra Wilson as Dr. Miranda Bailey *James Pickens, Jr. as Dr. Richard Webber *Kate Walsh as Dr. Addison Montgomery-Shepherd *Isaiah Washington as Dr. Preston Burke *Patrick Dempsey as Dr. Derek Shepherd Special Guest Star *Chris O'Donnell as Dr. Finn Dandridge Guest Stars *Sara Ramírez as Dr. Callie Torres *John Cho as Dr. Marshall Stone *Jeffrey Dean Morgan as Denny Duquette *Graham S. Beckel as Jim Johnson *Sarah LaFleur as Melanie Reynolds *Gabriel Tigerman as Noah Reynolds *Frances Fisher as Betty Johnson Co-Starring *John O'Brien as CT Tech #2 *Wayne Lopez as Paramedic #2 *Maile Flanagan as CT Tech #1 *Ray Ford as Ray the Paramedic *P.D. Mani as Anesthesiologist Featuring *Maria Elena Maglaris as Nurse Medical Notes Cristina's Patient *'Diagnosis:' **Paraesophageal hernia *'Doctors:' **Cristina Yang (surgical intern) *'Treatment:' **Surgery Cristina told the other interns about scrubbing in on a paraesophageal hernia. Noah Reynolds *'Diagnosis:' **Patella fracture *'Doctors:' **Callie Torres (orthopedic surgery resident) **Izzie Stevens (surgical intern) *'Treatment:' **Surgery Noah, 25, was brought into the ER after a car accident. He had pain in his right knee that was diagnosed as a patella fracture, for which he needed surgery. Melanie Reynolds *'Diagnosis:' **Catastrophic internal injuries *'Doctors:' **Derek Shepherd (neurosurgeon) **Preston Burke (cardiothoracic surgeon) **Addison Forbes Montgomery (fetal surgeon) **Richard Webber (general surgeon) **Miranda Bailey (surgical resident) **Cristina Yang (surgical intern) **Alex Karev (surgical intern) *'Treatment:' **Splenectomy **Lung resection **Surgery Melanie, 22, was pregnant and brought into the ER after a car accident. Her shock concealed the extent of her injuries, which were catastrophic. Once she relaxed, her body stopped producing adrenaline and she had to be rushed into surgery. They agreed in surgery due to her injuries that they needed to do damage control until she reached the triangle of death. Once she had reached that point, they packed her and moved her to ICU. They waited several hours and took her back into surgery. Despite their best efforts, she died on the table and her baby was delivered posthumously. Jim Johnson *'Diagnosis:' **Scalp laceration **Finger injury *'Doctors:' **Miranda Bailey (surgical resident) **George O'Malley (surgical intern) *'Treatment:' **Stitches **Bandaging Jim was brought to the hospital after being in a car accident. He had a scalp laceration. His scans were clear, so he was quickly discharged. He also had a finger that was bandaged. Betty Johnson *'Diagnosis:' *'Doctors:' **Alex Karev (surgical intern) *'Treatment:' Betty was brought to the ER after a car accident. She was examined in the ER, but her scans were clear, so she was quickly discharged. Marshall Stone *'Diagnosis:' **Closed head injury **Broken wrist *'Doctors:' **Derek Shepherd (neurosurgeon) **Callie Torres (orthopedic surgery resident) **Meredith Grey (surgical intern) **George O'Malley (surgical intern) *'Treatment:' **Splinting Marshall was brought into the ER after a car accident he caused. He was confused and had a closed head injury. He also had a broken wrist, which Callie reduced and splinted. He was then taken for a CT, which was clear. Denny Duquette, Jr. *'Diagnosis:' *'Doctors:' **Preston Burke (cardiothoracic surgeon) **Izzie Stevens (surgical intern) *'Treatment:' Denny pushed himself too far on his LVAD and collapsed. Marshall's Patient *'Diagnosis:' **Ruptured abdominal aortic aneurysm *'Doctors:' **Marshall Stone (surgical intern) *'Treatment:' **Surgery Marshall told Meredith that he was tired because he scrubbed in on an abdominal aortic aneurysm. Baby Reynolds *'Diagnosis:' *'Doctors:' **Addison Montgomery-Shepherd (neonatal surgeon) **Alex Karev (surgical intern) *'Treatment:' **NICU care Baby Reynolds was born just as Melanie died and taken to the NICU. Addison's Patient *'Diagnosis:' *'Doctors:' **Addison Montgomery-Shepherd (OB/GYN) *'Treatment:' **Surgery Addison had to leave Melanie Reynolds in order to operate on another patient. Music "Iguana" - Sergio Belem "Oh My Love" - Inara George "Tragedy" - Brandi Carlile "Nowhere Warm" - Kate Havnevik "On the Radio" - Regina Spektor Notes and Trivia *This episode's title originated from the song Damage Case, originally sung by Motörhead. *This episode scored 21.99 million viewers. *This episode is directed by Tony Goldwyn, who would later be cast as President Fitzgerald Grant III in Shonda Rhimes's other TV show Scandal. Gallery Episode Stills 2x24-1.jpg 2x24-2.jpg 2x24-3.jpg 2x24-5.jpg 2x24-4.jpg 2x24-6.jpg 2x24-7.jpg Quotes :Meredith: You don't get to call me a whore. When I met you, I thought I had found the person that I was going to spend the rest of my life with. I was done. So all the boys and all the bars. Who cared? Because I was done. You left me. You chose Addison. I'm all put back together now. I make no apologies for how I chose to repair what you broke. You don't get to call me a whore. :Derek: This thing with us is finished. It's over. :Meredith: Finally. :Derek: Yeah, it's done. :Meredith: It is done. ---- :Cristina: Don't worry about Bambi. If Burke can forgive me for falling asleep during sex, Bambi can forgive you for crying. :Meredith: But Burke hasn't forgiven you. ---- :Cristina: People! What's with all the evil misery, huh? Live and let live. :George: You're cheerful. :Izzie: You are. How is that possible? :Cristina: I scrubbed in on a four-hour esophageal surgery last night, then I got laid. And now, three ambulances are coming in full of bloody, broken car crash victims, all who need to be cut open. So I'm cheery, I'm cheery, I am so cheery! Cheery! I'm cheerful! ---- :Izzie: So what's the sex like? :Meredith: I wouldn't know. :Izzie: Four dates and two sleepovers and no sex? :Meredith: Not even a kiss goodnight. :Izzie: Aww, I'm so proud. I am like a proud mama. :Meredith: Shut up. ---- :Denny: Would it be really inappropriate for me to feel you up right now? :Izzie: Not really. ---- :Meredith: If you knew me... if you knew my family.. if I told you the guys that I've slept with lately... the scary and damaged may actually be more than you can handle. :Finn: My mother's dead. She got cancer when I was 10 and suffered for a really long time and then she died. My father never recovered. It's kind of like he died with her, except that he's above ground and permanently placed in front of a TV with a bottle of scotch in his lap. The last woman I slept with was my wife, but she died too. It was a car crash so it was quick. She didn't suffer, which I appreciated. Don't worry, I'm thinking that my luck is beginning to change, because I met you. You like dogs, and you enjoy pony births, and have the ability to save lives. I never said I wasn't scary and damaged too." See Also de:Totalschaden fr:A corps ouvert Category:All Episodes Category:GA Episodes Category:GA S2 Episodes